Elisabeth AVRIL is general practitioner and executive manager of Gaia Paris association whose missions are developing harm reduction among people who use drugs (NSP, low threshold OST program, DCR, hepatitis project, outreach work). As a clinician, she is involved in the HIV and HVC treatment of PWUD and substitution therapy.

Gaia is one of the leading Harm Reduction (HR) organisations in Paris, particularly known for starting the first and only Drug Consumption Room (DCR) in Paris, since 2016. Gaia’s outreach teams and mobile unit are long established, and have witnessed the emergence of growing open drug-scenes in Paris since about 20 years

DCR has always been a controversial topic. Consequently, a lot of local resistance is fighting very aggressively against the presence of the PWUDs and strongly oppose any potential creation of new services, including much-needed additional DCR.
Paris DCR benefited from multi-level governance: Paris steering committee, neighbourhood committee and monitoring committee. Following the mediation actions carried out before the implementation, Gaia acts to inform and raise awareness among the stakeholders in its environment (daily outreach work, visits of the premise, hotline for the neighbours, participation in institutional or associative meetings, awareness sessions for police and railways agents).

An important threat will be the end of the experimental period of the DCR planned for December 2025, knowing that some politicians want to shut it down. Concerned in the forefront, PWUDs are mobilizing and increasingly wish to participate in discussions on the future of the DCR. They wish to join with the local residents supporting the DCR in order to make their voices heard.

Today one group of residents allied with PWUD urge the local authorities to develop more healthcare services for PWUDs. A community response and a network involving PWUDs, residents, HR services and politicians are emerging in the debate.
This alliance is now moving to step two and start to pressure the authorities to build a collective comprehensive regional strategy for HR.